[Cytomegalovirus acalculous cholecystitis in an AIDS patient]. / Colecistitis alitiásica por citomegalovirus (CMV) en paciente con SIDA.

We report a case of acalculous cholecystitis in an AIDS patient, that appeared with insidious onset, abdominal right upper quadrant pain and fever. Cholecystectomy was performed and CMV inclusions were observed in tissue sections. CMV acalculous cholecystitis is an uncommon condition associated to the acquired immunodeficiency syndrome. It should be considered, especially when abdominal pain and fever are present in marked immunosuppressed AIDS patients. Unfortunately, a limited experience in treatment, either medical or surgical, was reported. In our case, the response to surgical procedure was successful, disappearing the abdominal pain and the fever. The patient refused both ganciclovir and foscarnet therapy.

[Cancer of the colon with a duodenal fistula. Its surgical treatment]. / Cáncer de colon fistulizado a duodeno. Su tratamiento quirúrgico.

The authors present an infrequent case: fistulization of a colonic cancer to duodenum. A side from its rarity, the case is interesting from the surgical point of view. Not many years ago, the fact that carcinoma of the hepatic angle had infiltrated the duodenum was interpreted as a sign of nonresectability. Now prognosis is not considered to depend on this complication, but instead, on tumoral stage, as in any other colonic tumor. The ideal technique is block resection, which requires enlarged right hemicolectomy and partial excision of the duodenum, if possible, or cephalic duodenopancreatectomy in selected cases. Although appreciable survival rates have been reported in this situation, the most important benefit may be an improved quality of life for the patient if resection is not curative.

[Decrease in postoperative mortality caused by bleeding peptic ulcer]. / Descenso de la mortalidad postoperatoria de la úlcera péptica sangrante.

Hemorrhage continues to be a serious complication of peptic ulcer, especially in patients over 65 years. Gastric location, delay in the surgical intervention, the amount and characteristics of hemorrhage and the use of laborious resection techniques are factors that worsen the prognosis and contribute to increased mortality. In the authors' experience, the comparison of two series separated in time led them to conclude that restriction of the use of resection techniques for gastric ulcers and improved medical-surgical collaboration, facilitated by use of a special protocol for bleeding peptic ulcers, has reduced mortality from 12.5% to 4.08% in 49 patients operated in the last 3 years.